MEDICAL PHYSIOLOGY

Guyton & Hall text book of Medical Physiology 13th edition

NESAR A. ZAHIER, MD, PGD

LECTURER & TRAINER SPECIALIST, KUMS

1
‫بسم هللا الرحمن الرحیم‬

‫‪2‬‬
CONTRACTION OF -6
SKELETAL MUSCLE
Skeletal muscle

 40%  skeletal muscle

 10%  cardiac & smooth muscles
 ANATOMY

 Muscle fibers  10-80mcm

 Sarcolema  plasma membrane + collagen fibrils
 ?100 Myofibrils  3000 Actin + 1500 Myosin
filaments
 Sarcomere  between 2 Z disks
 Titin  side by side relationship - keep actin &
myosin in place
…Continued

 Sarcoplasm  space between

myofibrils  K, Mg, Phosphate,
enzymes… & mitochondria
 Sarcoplasmic Reticulum 
surrounding myofibrils  Ca
storage
MUSCLE CONTRACTION 1

 Sequential steps 2
1. Action potential travels along
nerve
3
2. Nerve Endings  acetylcholine 4
3. In muscle fiber AC gated channels
4. Voltage gated Na+ channels
5
5. Action potential travels along
muscle fiber
6. Sarcoplasmic Reticulum  Ca++
7. Actin & Myosin slide alongside
6. SR  Ca++
8. Ca++ pump back to SR 
contraction ceases
…MOLECULAR MECHANISM
 Myosin filament = ?multiple Myosin
molecules
 2 heavy chains & 4 light chains Myosin
molecule
 Myosin head  ATPase enzyme
 Actin Filaments = Actin +
Tropomysosin + Troponin
 Troponin
 Troponin I  Actin
 Myosin
Troponin T  Tropomyosin
filament
 Troponin C  Ca = contraction
Muscle Contraction
actin

Ca myosin
 1 myosin filament + 2 actin
filaments + Ca ions = contraction actin
 Rest  Inhibition of Actin
Filament by Troponin-Tropomyosin
complex
 Activation of Actin filament by Ca
ions
 Activated Actin Filament + Myosin
cross-bridges = Walk Along
ATP
 ATP source of contraction
Fenn
effect: high
work 
high ATP
cleaved
…POINTS
 The amount of actin and myosin
filament overlap determines
tension developed by the
contracting muscle

 Velocity decreases as the load

increases
ENERGETICS OF MUSCLE CONTRACTION
 Work output during muscle
contraction; W = Load * Distance 3. Oxidative
metabolism
 3 sources of energy for muscle of foodstuffs
contraction
1. Phosphocreatine= creatine Energy 2. Glycogen
phosphate  phosphorelated (ATP) storage
creatine molecule works as a
rapidly reserve for energy to 1. Phosphocreatine  ATP
recycle ATP
Load
2. Glycolysis of glycogen
distance
3. Oxidative metabolism of
carbohydrates, fats & proteins 
95% energy
WHOLE MUSCLE CONTRACTION

 Isometric = not shorten + tension

increases
 Isotonic = shorten + constant
tension

Weight
increased

Constant weight
 …Continued
Mechanics Of Skeletal Muscle
Contraction
 Motor Unit  single nerve fiber + all
innervated muscle fibers
 Force summation  increase
overall intensity of muscle
1. Increasing the number of motor units
2. Increasing contraction Frequency 
tetanization
…Continued
 staircase effect (treppe) = strength
in increased because increasing Ca
in cytosol
 Muscle tone = low rate of impulses
during rest  low rate of nerve
impulses
 Muscle Fatigue =prolong and long
contractions  depletion of muscle
glycogen 5 Increase Ca++
4 in cytosol
3
2
1
After long rest

Muscle strength
 REMODELING OF MUSCLE TO MATCH
FUNCTION
Remodeling  change in diameter, length,
strength and vascularity to match the function
 Hypertrophy = total mass increased  actin
& myosin fibers in each muscle fiber and
contractile proteins
 Atrophy = unused muscle >  degradation of
contractile proteins
 Proteosomes (lysosomes)  proteolysis
 Increasing length  increasing sarcomeres
 Hyperplasia of muscle fibers  fibers
 Denervation of muscle  rapid atrophy
Clinical points

 Poliomyelitis  some nerve fibers  Muscular dystrophy  inherited

destroyed  remaining fibers form disorders  progressive muscle
new axons  enervates more weakness and denervation
muscles but decrease the fineness  e.x. Duchene muscular dystrophy
of control = MACROMOTOR UNITS
 Rigor Mortis  muscles contracts
and became rigid in first few hours
 losing of ATP to separate cross
bridges  until autolysis occurs
THANKS